Bruising happens when blood becomes trapped under the skin, usually due to an impact that damages a small blood vessel. Minor bruises often heal in a few days. Some people bruise more easily than others, and the bruising can take longer to heal.

A fall, blow, or anything else that exerts sudden high pressure on the skin can cause a bruise. Very forceful blows can damage bones, causing deep bleeding and bruises that take several weeks to heal.

Some people bruise more easily than others. They may notice bruises but not know why they happened. They may also develop large bruises after minor injuries or have bruises that take many weeks to heal.

Factors that increase the risk include older age, having a condition that affects blood clotting, and using medications such as blood thinners.

Here, find out some reasons one person may bruise more easily than another.

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A bruise develops when blood vessels become damaged, and blood leaks into tissues under the skin. This causes the characteristic black or purple color of a bruise.

On dark skin, bruising may also appear red or purple, or it may show as a darker area than the surrounding skin, depending on the person’s skin tone.

In time, body tissues absorb the blood, and the color fades.

Here, learn more about how bruising appears on dark skin.

Some signs that an individual bruises more easily than an average person include:

  • developing very large, painful bruises after minor injuries
  • having many bruises without remembering their cause
  • frequently developing bruises that take many weeks to heal

Numerous factors can cause a person to bruise more easily. The most common include the following:

People tend to bruise more easily with age, because blood vessels weaken, and the skin thins.

Easy bruising may also run in families, so individuals whose relatives bruise easily may notice that they do too.

Medications

Blood-thinning medications may cause a person to bleed and bruise more.

Some popular blood thinners include:

Some other medications may weaken or change the behavior of blood vessels, worsen inflammation, or otherwise increase the risk of bleeding. They can include the following:

People taking medication who notice an increase in bleeding or bruising should ask a doctor whether their medication can cause bleeding. They may wish to discuss the risks and benefits of continuing treatment.

Liver disease

Cirrhosis and other conditions can have an impact on liver function. Liver disease can affect blood clotting, which can increase the risk of bleeding and easy bruising.

Other symptoms of liver disease include:

  • itching
  • fatigue
  • a general feeling of being unwell
  • swelling in the legs
  • dark urine
  • yellowing in the whites of the eyes, a sign of jaundice

Alcohol is a major contributing factor to liver disease, but the condition can also result from cancer and other health issues.

Learn more about the symptoms of liver disease here.

Bleeding disorders

Many genetic conditions can affect blood clotting.

Von Willebrand’s disease, the most prevalent bleeding disorder, affects about 1% of the population. A person with this condition has little or no von Willebrand protein, which is important for blood clotting. Synthetic hormone treatment can improve blood clotting in people with the condition.

Hemophilia involves low levels of blood clotting factor VIII (hemophilia A) or factor IX (hemophilia B). Both proteins are important for blood clotting. Synthetic versions of these clotting factors can help treat hemophilia and reduce the risk of serious bleeding and bruising.

A person with a genetic bleeding disorder has a higher risk of bruising and excessive, possibly life threatening bleeding. The bruises will look like regular bruises, but they can be larger.

The symptoms will be present from birth and can affect babies and young children.

Vitamin deficiencies

Certain vitamins enable the body to heal and the blood to clot.

Low vitamin C levels can cause a condition called scurvy. The body uses vitamin C in creating collagen, an essential part of the structure of blood vessels. In scurvy, the blood vessels weaken, resulting in:

  • bleeding gums
  • wounds that do not heal
  • easy bruising

Vitamin K helps the body form clots to stop bleeding. Newborns often have very low levels of vitamin K, which are insufficient to stop bleeding. Without a vitamin K injection at birth, babies may bruise easily or bleed excessively. Adults with low vitamin K levels may also notice a sudden increase in bruising.

A doctor can carry out tests to see whether a person has a vitamin deficiency. In some cases, supplements or a change in diet can help. In other cases, an underlying health condition, such as inflammatory bowel disease, may need addressing.

Vasculitis

Vasculitis refers to a group of conditions that cause inflamed blood vessels.

Symptoms include:

  • increased bleeding and bruising
  • shortness of breath
  • numbness in the limbs
  • ulcers
  • skin lumps
  • purple spots on the skin, known as petechiae

On dark skin, petechiae may not always show up, which means a doctor could miss them. They may be visible in areas with less melanin, such as the forearms.

The type of treatment depends on the severity of the vasculitis and which area of the body it affects. Several medications, including steroids, may help.

Senile purpura

Senile purpura is common among older adults, affecting around 10% of those aged over 50 years. It causes dark purple bruise-like lesions on the skin and is most likely to develop on the arms and hands.

They are more common in people with light skin, but anyone can develop them. On Brown and Black skin, they may appear purple or as darker skin. The skin around may be thinner and less elastic.

The lesions often appear after an injury to the skin but last longer than bruises and can be much larger. Sometimes, the skin remains brown after the lesion heals.

Ways of reducing the risk of bruising include:

  • protecting the skin from sunlight
  • taking care to avoid injuries
  • being aware that corticosteroids and blood-thinning drugs can worsen symptoms

Senile purpura does not have links with any serious health condition, but it may increase the risk of skin tears.

Cancer

Rarely, an increase in bleeding and bruising may be a sign of leukemia. This is a type of cancer that affects white blood cells.

There are different types of leukemia, and symptoms vary.

Often, there are no symptoms in the early stages, but a person may notice:

  • bleeding
  • bruising
  • petechiae, small spots under the skin, like a rash, where blood vessels have broken
  • fever
  • fatigue
  • bone pain
  • heavy menstruation
  • abdominal swelling

Petechiae may not be visible on dark skin, but a person may see them on areas with lower levels of melanin, such as the forearms.

Anyone who experiences these symptoms should seek prompt medical advice, as early treatment is often effective.

What is a leukemia rash?

Bruises usually fade in time and do not need treatment. However, first aid after an injury may help reduce swelling and discomfort.

First aid for a bruise after an injury involves:

  1. ensuring the person is comfortable
  2. raising and supporting the injured part
  3. applying a cold pack or ice wrapped in a cloth for 20 minutes, as this can reduce swelling

Never apply ice directly to the skin.

Other treatment options include using pain relief medication, such as ibuprofen. Some people apply arnica to the skin, but there is not enough evidence to show it speeds up healing.

People who bruise easily may need medical help for an underlying condition.

How can I get rid of a black eye?

People should consult a doctor about easy bruising if:

  • bruising occurs more often or more severely than before
  • they have other symptoms, such as fever, low energy, or skin changes
  • they are taking medication and begin bruising more easily
  • bruises are slow to heal
  • they notice petechiae, small red spots resembling a rash under the skin
  • they develop purpura, purple patches under the skin

A person should seek emergency help if a large bruise develops after a trauma, especially if they also have lightheadedness or dizziness. These could be signs of internal bleeding.

What do the colors of a bruise mean?

Here are some questions people often ask about easy bruising.

Do older adults bruise more easily?

Older adults often bruise more easily, because the skin becomes less flexible with age, and there is less fat to protect the blood vessels. Sun exposure can also increase the risk.

Does diabetes affect bruising?

In people with diabetes, wounds, including bruises, can take longer to heal.

What is the treatment for a bruise?

Bruises usually heal without treatment, but raising the bruised part and applying ice covered in a cloth may help reduce swelling.

In most cases, a person who bruises easily is unlikely to develop complications after a bruise.

However, easy bruising can be a sign of an underlying condition and a higher risk of bleeding overall.

Anyone who notices they are bruising more often or more easily than usual should seek medical advice to rule out other health issues or seek treatment as appropriate.